RESUMO
Differentiated thyroid cancer (DTC) is the most common type of thyroid cancer. Most of patients with DTC are characterized by low invasiveness and good prognosis. With the development of medical imaging, fine needle biopsy and molecular biology technology, especially the progress of surgical technology, the early diagnosis rate of DTC and the survival rate after operation are significantly increased. However, the cognition understanding of DTC and some views of surgical treatment are still controversial. A systematic review and summary of the diagnosis and surgical treatment of DTC are made based on the changes in the past 40 years, especially the treatment strategy, surgical resection scope and indications of DTC primary focus and cervical lymph node metastasis, in order to propose a more reasonable and accurate individual diagnosis and treatment plan for patients with DTC.
RESUMO
Objective To evaluate the clinical value of lymph node micrometastases in central group(Ⅵ) lymph node in follicular carcinoma of thyroid.Methods Three hundred and twenty-six negative neck lymph nodes in 68 cases on routine pathological examination(pN0) were examined by keratin-19 monoclonal antibody and S-P immunohistochemistry to detect expression of keratin-19 to confirm lymph node micrometastasis in each neck lymph node,and compare the pathological type and follow-up data of all cases.ResultsThere were 46 neck lymph nodes showed positive lymph node micrometastasis among 326 negative neck lymph nodes that included 4 lymph nodes in group Ⅱ(4/42),5 lymph nodes in group Ⅲ(5/34),5 lymph nodes in group Ⅳ(5/49),1 lymph node in groupⅤ(1/17) and 31 lymph nodes in group Ⅵ(31/184).6 in 14 cases with positive lymph node micrometastases showed distant metastasis or local recurrence,but only 3 in 54 cases with negative lymph node that micrometastases distant metastasis or local recurrence(P